MEDICARE: JEFFREY STEUCK PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	16635-24	WI

General Provider Information

NPI Number	:	1801650999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY STEUCK PT, DPT

Provider Business Mailing Address
First Line	:	24014 W RENWICK RD UNIT 206
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60544-8711
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8201 S HOWELL AVE STE 400
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-8336
Country	:	US
Telephone Number	:	414-295-9045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2024
Last Update Date	:	02/08/2024

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